Skip to main content

Accident Reports

Accident / Incident Report

This new form is to be used for all injuries and accidents for staff and students. Reports must be filled as soon as possible for:

injuries

severe illness/exposure

theft / vandalism

property loss / damage

 

 

*EMPLOYEE INCIDENTS STUDENT INJURIES

 

All employee injuries and accidents should be reported immediately after calling the Work Injury Line: 

707-836-7457

 Student accidents requring attention beyond basic first aid should also be submited by the employee who witnesses or was suprvising the student at the time of injury. 

 

*See below for additional information about reporting serious workplace incidents to Cal/OSHA

Accident / Incident Report

RESIG INSTRUCTIONS FOR CAL OSHA

District Requirements for Reporting A Serious Injury/ Illness to CalOSHA

Reporting must be done within 8 hours of the incident or knowledge of the incident

Cal/OSHA Enforcement Unit District Office

Phone: (707) 649-3700
Fax: (707) 649-3712

 

American Canyon District Office
3419 Broadway Street
Suite H8
American Canyon, CA 94503

 

Cal OSHA Reporting Checklist:

Time and date of accident

Employer’s name, address, and telephone number

Name and job title or badge number of person reporting the accident

Address of accident or event

Name of person to contact at the site of accident

Names & address of injured employee(s)

Nature of Injury

Location where injured employee(s) was (were) taken for medical treatment

List and identity of other law enforcement agencies present at the site of accident/event

Description of accident/event

Ehether the accident scene or instrumentality has been altered

 

ADDITIONAL RESIG UPDATES MAY BE AVAILABLE HERE